Committee (5th Day)

Part of Health and Social Care Bill – in the House of Lords at 7:00 pm on 14th November 2011.

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Photo of Lord Greaves Lord Greaves Liberal Democrat 7:00 pm, 14th November 2011

I am extremely flattered that the noble Lord, Lord Warner, thinks that I have the slightest idea where it is going to end up. I am doing exactly what the noble Lord, Lord Warner, and other noble Lords are doing-trying to get the Minister to give us some idea of that. We will be interested to see whether he gives that. Over the political lifetime of this subject, we have had constant changes. We started with bigger area health authorities and smaller district health authorities, going down to district level, and then going back to the area level, with the regional level having a greater or lesser influence. The fact is that this is a fundamental administrative difficulty-not a philosophical difficulty-for an organisation like the health service.

Everybody tends to think that what they have at the moment is not perfect and therefore they try to change it. Because there are only a limited number of options available, it goes backwards and forwards, from local to less local back to local again. If the noble Lord thinks that I know what is going to happen, I am afraid that I do not have the slightest idea. It seems to me that we need a clear idea of what this Bill is going to result in when it leaves this House and we need to understand how it is going to work. In a sense, the details of that matter less than the workability of it.

The point that I was making about "commissioning" being used with two different meanings is that it is used for a particular GP practice commissioning services for the people on its list-